'Maternal healthcare desert in Commonwealth': Rural Virginians struggle with abortion access

At a Glance: Southwest Virginia resident and mother of two, Dana shares her story of limited access to maternal healthcare and abortion services when in need. Her story is among the thousands living in a ‘maternal healthcare desert’ as nearly 70% of rural Virginia lacks nearby maternal or abortion care facilities.

When Dana, a mother of two from southwest Virginia, needed an abortion last November, she confronted an unexpected financial barrier that threatened her family's well-being.

“There was no other choice for me,” Dana, 32, said. "Going through with this pregnancy was not something I could afford. With all the health issues, possible medical complications (and) maternity expenses, I would be paying a heavier price than having an abortion. It would put my existing family at risk too.”

Due to medical and financial reasons, Dana– who did want her full name disclosed for privacy and safety reasons– decided abortion was the best health decision for her and her loved ones. But getting an abortion for Dana was not very affordable either.

Dana's experience highlights the economic struggles many face while accessing abortion services in Virginia, as the financial burdens extend well beyond medical expenses.

"The reality of the matter is most people don't know about abortions right until they need to experience it," said Stephanie Nash, the executive director of Blue Ridge Abortion Fund based in Virginia. The organization provides financial support, transportation and lodging assistance for abortions.

At 10 weeks pregnant, Dana turned to the clinics nearby. Residing in a rural county, the closest provider was a one-hour drive and two weeks of a waitlist away.

“I was already experiencing morning sickness and other changes to my body that made working regular shifts so much harder,” Dana said. “At that time, waiting for two weeks felt like forever. I did not want to go through that physically or mentally.”

Facing limited options, Dana opted to travel to Richmond. But that meant factoring in travel, hotel and meal costs that further strained her tight budget. Living paycheck to paycheck, she sought help from the Blue Ridge Abortion Fund, which provided her crucial financial assistance for travel and the procedure.

Dana's struggle to access abortion services sheds light on the challenges many individuals face in similar situations. For the nearly 70% of rural communities in Virginia lacking nearby maternal or abortion care facilities, accessing reproductive healthcare comes with significant challenges, according to Axios’ Feburary 2024 report.

“We have a maternal healthcare desert in the Commonwealth,” said Galina Varchena, director of policy at Birth in Color, a local organization aiming to remove healthcare access barriers for people of color.

“We have hospitals that are closing down their OB unit, or closing down altogether,” she continued. “We have a rural population that really does not have good access to health care. Folks there tend to not have insurance for their health needs. In addition to abortion costs, or even just for general health, they have to travel further to avail them.”

The average cost of an abortion procedure alone varies depending on gestational age. Medication abortion– offered up to 11 weeks of gestation– typically ranges from $650 to $700. For those within 12-16 weeks of gestation, the procedure can range from $1,300 to $1,600 on average.

A second-trimester procedure beyond 20 weeks could cost as high as $15,000, Nash said. The third-trimester abortions, which typically happen when there is a complication with the fetus such as the absence of a heartbeat, could go up to $30,000.

A typical biweekly paycheck for a Virginian hovers around $2,000.

While some private insurance plans may cover abortion, Medicaid and most other plans do not. State funding may be used for abortion in Virginia in cases of rape, incest, fetus abnormality, and viability, or if the pregnancy threatens the health or life of the mother.

Working in the service industry, Dana said she already struggled to cover her family's needs and childcare expenses. Her procedure, including medication, lodging, travel, and childcare services, amounted to just under $700 out of pocket. Without Blue Ridge’s funding assistance, Dana said, it would have cost closer to $1,500.

Marginalized communities, especially women of color, often encounter greater difficulties accessing abortion due to limited health insurance coverage, Varchena said, as they often work jobs that lack paid leave benefits, resulting in additional financial burdens.

“There's a significant number of women of color, who are also single moms, who might live in situations where they don't have a lot of family or community support to help take on some of those additional burdens,” Varchena said. “So, these kinds of costs tend to compound already existing disparities and inequities. That's why when we talk about abortion we also talk about abortion access.”

In 2022, Blue Ridge's Impact Report disclosed $810,659 in funding for 1,519 patients across 28 states. Of this, $733,836 went towards abortion costs, with $76,823 allocated to practical support, covering expenses such as travel and lodging. On average, each individual received $235 in support.

Following the reversal of Roe v. Wade, Blue Ridge experienced a surge in donor contributions. This influx of financial support allowed the organization to broaden its funding for individuals seeking abortions amid a significant rise in demand.

“Abortion care is not an issue of rights, it's an issue of access,” Nash said. “Black and brown people have always been at a disadvantage in the issue of abortion. Communities of color oftentimes faced an increase in barrier to be able to receive it.”



*Dana M., 33 lives in Virginia and works in service industry. For safety and privacy reasons, Dana did not want her full name disclosed. This news story used her first name with her consent.

Image Credits: Zulkarnieiev at iStock images